Genicular Artery Embolization to Improve Pain and Function in Early-Stage Knee Osteoarthritis—24-Month Pilot Study Results

Landers, Steve; Hely, Rachael; Page, Richard; Maister, Nick; Hely, Andrew; Harrison, Benjamin; Gill, Stephen D.

doi:10.1016/j.jvir.2020.05.007

Cited by 57 publications

(39 citation statements)

References 18 publications

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“…Interestingly, when present, the pain desisted immediately following embolization. This phenomenon has been reported by other authors, and warrants further study [8,9,12].…”

Section: Discussionsupporting

confidence: 82%

“…Laboratory and animal experiments have identified the role of neo-angiogenesis in the pathophysiology of knee OA, and this has emerged as a viable embolization target. Existing human data, including the current work, have all reported a consistent signal that GAE is safe, technically achievable, and beneficial in reducing pain, and functional limitation secondary to mild to moderate knee OA at early follow-up [ 8 – 12 ]. The current analysis is the largest reported cohort with mild to moderate knee OA undergoing GAE with a permanent embolic.…”

Section: Discussionmentioning

confidence: 63%

“…Okuno et al were the first group to describe their experience of genicular artery embolization (GAE) in patients with knee OA [8]. Since then, a small number of studies have reported on the role of GAE in the treatment of knee OA [8][9][10][11][12]. The Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the knee (GENESIS) study investigates the safety and feasibility of performing GAE in patients with mild to moderate knee OA using permanent microspheres.…”

Section: Introductionmentioning

confidence: 99%

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Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis

Little

Gibson

Briggs

et al. 2021

Cardiovasc Intervent Radiol

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Purpose Planned interim analysis of GENESIS; a prospective pilot study investigating the role of genicular artery embolization (GAE) in patients with mild to moderate osteoarthritis of the knee using permanent microspheres. Methods Thirty-eight patients, median age = 60 (45–83), attended for GAE using 100–300 μm permanent microspheres. All patients had mild to moderate knee OA, resistant to conservative treatments over 6 months. Knee MRI was performed at baseline, and 12 months, enabling semi-quantitative analysis using Whole-Organ Magnetic Resonance Imaging Score (WORMS). Knee Injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS) (0–100 mm) were completed at baseline, 6 weeks, 3 months (n = 32), and 1-year (n = 16). Adverse events were recorded prospectively. Results Technical success of accessing and embolizing the target genicular arteries was 84%. Six patients were not embolized: four due to a presumed risk of non-target embolization, and two due to a lack of hyperaemic target. Mean VAS improved from 60 (SD = 20, 95% CI 53–66) at baseline to 36 (SD = 24, 95% CI 28–44) at 3 months (p < 0.001) and 45 (SD = 30, 95% CI 30–60) at 1-year (p < 0.05). All KOOS subscales showed a significant improvement at 6-weeks, 3-months, and 1-year follow-up, except function in daily living, which reached borderline significance (p = 0.06) at 1-year. Four patients experienced mild self-limiting skin discoloration over the embolized territory. One patient experienced a small self-limiting groin haematoma. WORMS scores at 1-year follow-up showed significant improvement in synovitis (p < 0.05). There were no cases of osteonecrosis. Conclusion GAE using permanent microspheres in patients with mild to moderate knee OA is safe, with potential efficacy at early follow-up.

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“…Interestingly, when present, the pain desisted immediately following embolization. This phenomenon has been reported by other authors, and warrants further study [8,9,12].…”

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 63%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis

Little

Gibson

Briggs

et al. 2021

Cardiovasc Intervent Radiol

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“…The limited published data available suggest that GAE is effective in reducing knee pain from OA (36,37,(41)(42)(43). These studies include single-arm prospective trials, a retrospective case series, and a systematic review.…”

Section: Gae (Current Clinical Evidence)mentioning

confidence: 99%

Percutaneous Management of Osteoarthritis in the Knee: Proceedings from the Society of Interventional Radiology Research Consensus Panel

Ahmed

Block

Mautner

et al. 2021

Journal of Vascular and Interventional Radiology

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GAE ¼ genicular artery embolization, GNA ¼ genicular nerve ablation, NSAIDs ¼ nonsteroidal anti-inflammatory drugs, OA ¼ osteoarthritis, RCP ¼ research consensus panel, TKA ¼ total knee arthroplasty BACKGROUND Osteoarthritis (OA) of the knee is a complex, multifactorial disease with no known cure (1). Treatment options seek to manage symptoms, since no proven disease-modifying therapies currently exist. However, for many patients, adequate and sustained symptom control can be challenging to achieve. Depending on disease severity, various

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“…8-10 Since the initial trial by Okuno et al in 2013, multiple studies have been conducted worldwide culminating in a randomized control study in the United States that highlighted the effectiveness of GAE compared to a sham procedure. [11][12][13][14][15] The purpose of this article is to describe the literature on GAE and highlight the latest findings from the randomized sham-controlled trial.…”

mentioning

confidence: 99%

Musculoskeletal Interventions: A Review on Genicular Artery Embolization

Sajan

Bagla²,

Isaacson

2021

Semin intervent Radiol

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Symptomatic knee pain is one of the most common joint diseases that affects millions of people worldwide. The treatment for knee pain secondary to osteoarthritis (OA) begins with conservative therapy and progresses to surgical intervention when conservative therapy fails. Genicular artery embolization (GAE) offers an alternative option for patients who are poor surgical candidates. Multiple studies have been conducted worldwide demonstrating the safety and efficacy of GAE in patients with mild to moderate OA. The purpose of this article is to describe the current literature on GAE and highlight the latest findings from a randomized controlled trial comparing GAE versus sham embolization.

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Genicular Artery Embolization to Improve Pain and Function in Early-Stage Knee Osteoarthritis—24-Month Pilot Study Results

Cited by 57 publications

References 18 publications

Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis

Genicular artEry embolizatioN in patiEnts with oSteoarthrItiS of the Knee (GENESIS) Using Permanent Microspheres: Interim Analysis

Percutaneous Management of Osteoarthritis in the Knee: Proceedings from the Society of Interventional Radiology Research Consensus Panel

Musculoskeletal Interventions: A Review on Genicular Artery Embolization

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